Scielo RSS <![CDATA[Health SA Gesondheid (Online)]]> vol. 27 num. lang. pt <![CDATA[SciELO Logo]]> <![CDATA[<b>The neonatal transfer process through the lens of neonatologists at public hospitals in South Africa</b>]]> BACKGROUND: Neonatal care is provided by various levels of healthcare facilities in South Africa. Intensive care for neonates is only provided at the higher levels, hence the need for transfers from lower-level to higher-level facilities (e.g. primary hospitals to tertiary hospitals) or across levels of facilities, particularly when life-threatening situations arise (e.g. cardiac deterioration, respiratory deterioration and desaturationAIM: The aim of the study was to explore neonatologists' views regarding the neonatal transfer process and to describe the preparedness of advanced life support (ALS) paramedics to undertake such transfersSETTING: The setting consisted of neonatologists from three provinces i.e. KwaZulu-Natal, Gauteng and Western capeMETHOD: A qualitative descriptive design was utilised in this study. Semistructured interviews were conducted on the public health hospitals in three provinces (N = 9; n = 3) with neonatologists (N = 7; n = 7) who were involved in the transfers of critically ill neonates. The process of thematic analysis was usedRESULTS: The themes that emerged in this study were: an awareness of local contextual realities related to neonatal transfers, challenges evident within the context of neonatal transfers, decision-making around the transfer of ill neonates, ALS paramedic preparedness for transfers and good clinical governanceCONCLUSION: The study found that there was a need to be aware of local contextual realities confronting neonatal transfers, a need for greater preparedness for paramedics to undertake these transfers, a need for a sound referral processes and a need for coordinated transfer effort between paramedics, hospital staff and transport team members for the successful transfer of critically ill neonatesCONTRIBUTION: The findings highlight the challenges confronting the neonatal transfer process in South Africa through the lens of neonatologist at public hospitals. Hence, the study reinforces the preparedness and coordination of the transfer process, along with more efficient communication between paramedics, hospital staff and the transfer team <![CDATA[<b>The association between objectively measured physical activity and health-related quality of life, life-space mobility and successful ageing in older Indian adults</b>]]> BACKGROUND: Longevity is increasing, accompanied by a rise in disability and chronic diseases with physical activity (PA) delaying disability, ensuring successful ageing (SA) and independent living in older adultsAIM: This study aimed to determine objectively measure PA levels, health-related quality of life (HRQoL), life-space mobility and SA of older adults as well as their mutual associationsSETTING: KwaZulu-Natal province, South AfricaMETHODS: A total of 210 older adults aged 65-92 years were purposively sampled and completed the Medical Outcomes Study 36-Item Short-Form Health Survey, the Life-Space Mobility, and Successful Ageing questionnaires. Physical activity levels were measured using an Omron Pedometer, which the participants wore for seven consecutive daysRESULTS: The average number of steps taken per day for the 7 days was 2025, with 98.6% of the entire study population classified as sedentary. The Vitality domain (one of 8 categorised) reflected the best health status (M = 59.9, s.d. ± 18.8) with a significant 93% of the participants indicating that they had not visited places outside their immediate neighbourhood (p < 0.0005). A significant, negative association between the average number of steps taken in 7 days and all three SA variables, namely, the physical (r = -0.152, p = 0.027), sociological (r = -0.148, p = 0.032) and psychological (r = -0.176, p = 0.010), and a significant, positive association with life-space mobility (r = 0.224, p = 0.001) was notedCONCLUSION: The majority of the older adults were sedentary, affecting their HRQoL, life-space mobility, and SA negativelyCONTRIBUTION: It is imperative to develop effective physical activity programmes to ensure successful ageing by improving older adults' quality of life and physical activity levels <![CDATA[<b>Linking the processes of medication administration to medication errors in the elderly</b>]]> BACKGROUND: Older people are more prone to chronic diseases than younger ones and typically receive multiple medications. Medication rounds in long-term care facilities (LTCFs) are usually lengthy, with most errors occurring during the administration phase. How nurses apply medication administration processes can affect resident outcomesAIM: To determine the processes of medication administration followed by nurses in LTCFs as self-reported by them to identify possible factors associated with medication errorsSETTING: Twenty-eight LTCFs for the elderly in the Western Cape province, South AfricaMETHODS: A non-experimental cross-sectional descriptive design was applied, using a quantitative approach. A stratified sampling method obtained equal samples of nurses from funded and private LTCFs, thus N = 123 respondents. Data collection was via self-administered questionnaires. The Statistical Package for the Social Sciences (SPSS27) was used for descriptive and inferential analysisRESULTS: Nurses' self-reported medication errors such as the sharing of medication between residents (83%), the omission of doses (64.8%), neglecting to sign after medication administration (57%), and medication administered at the wrong time (50.8%). Frequent interruptions during medication rounds were the most common reason for medication errors (75.6%CONCLUSION: Multiple medication administration process errors were self-reported by the nurses. LTCFs should provide mandatory medication training, monitor the adherence to correct medication administration procedures, and implement risk-management strategiesCONTRIBUTION: The identified factors associated with medication errors during medication administration processes can assist with developing risk management strategies and policies in the LTCFs and improve evidence-based practice and resident outcomes <![CDATA[<b>Factors that Master of Nursing students associate with study progress in higher education institutions in Gauteng province</b>]]> BACKGROUND: Globally, the unsatisfactory progress of postgraduate students registered for a master's degree is a cause for concern. It affects graduation numbers and completion timeAIM: This study aimed to determine the perceived supervisory-researcher community support, research writing, work-life balance, and research conceptions factors that Master of Nursing students associate with study progressSETTING: The study was conducted in three selected higher education institutions (HEIs) in the Gauteng provinceMETHOD: A correlational cross-sectional research design was utilised. A self-administered questionnaire adapted from the Cross-Country Doctoral Experience Survey was e-mailed to a total sample of 136 Master of Nursing students who were at least in their second year of study, of which 122 (89.7%) responded. Descriptive statistics, factor analysis, the Mann-Whitney U test, and the Kruskal-Wallis test were used to analyse the responsesRESULTS: Most of the students' perception was greater regarding supervisory-researcher community support and research conceptions. Despite a high mean composite score of 4.134 (SD-1.452) on work-life balance, some respondents found it difficult to balance work and life. Respondents with a source of income perceived greater supervisory-researcher community support (p = 0.022) while those studying full-time had better research writing perceptions (p = 0.002CONCLUSION: There is need for HEIs to develop or strengthen interventions targeting research writing and work-life balance factors that were perceived to result in less support. Funding remains a concern for Master of Nursing studentsCONTRIBUTION: This study contributes to knowledge on factors that Master of Nursing students associated with study progress <![CDATA[<b>Expert opinions on knowledge-translation interventions for occupational therapists working with neonates in South Africa: A Delphi study</b>]]> BACKGROUND: There is a paucity of literature on knowledge translation (KT) interventions for occupational therapists (OTs) in assessing and caring for the neonate and at-risk infant. Care at this stage of life is paramount, requiring a shift from the survival of the neonate, to the quality of survival. Consequently, clinicians working with neonates have a crucial role in ensuring optimal development and preventing long-term adverse developmental outcomesAIM: This study aimed to explore experts' opinions on KT interventions for OTs working with neonates and at-risk infants in South AfricaSETTING: This study was located in South Africa. Due to the virtual nature of data collection, no geographical limitations within the country were imposedMETHOD: A two-round Delphi study with a multidisciplinary expert panel (n = 20; n = 18) was conducted. The round one survey was developed based on a literature review, findings from a preceding focus group, and a pilot study. The subsequent round was based on the data and comments generated from the first round. Results were pooled and presented to participants following both roundsRESULTS: Consensus on 127 items out of 130 was achieved. These included consensus on the definition of KT in neonatal care, the knowledge that OTs should possess, professional competencies, skills required, professional values, and characteristics. Further agreement was reached on the KT process, the usefulness of KT modalities, recommended courses in neonatal care, barriers to KT, best-practice and requirements for undergraduate trainingCONCLUSION: Knowledge translation required for OTs working with neonates and at-risk infants were established in this studyCONTRIBUTION: This study may be useful for consideration in contextually relevant KT interventions for clinicians working in neonatal care <![CDATA[<b>Nurse managers' leadership roles in mining primary healthcare settings in Gauteng</b>]]> BACKGROUND: Nurse managers carry the light of leadership in mining primary healthcare settings (mPHCs). They must ensure that this light shines for their followers to improve the quality of service rendered in primary healthcare. However, the nurse managers in mPHCs are confusing their leadership roles with management roles. The existing policies such as operational management of mPHCs are also not clarifying the leadership roles of nurse managersAIM: The purpose of this study was to understand the nurse managers' leadership roles in mPHCsSETTING: This study was conducted in mPHCs, situated in Gauteng province, in the West Rand in 2017METHODS: A qualitative, exploratory, descriptive and contextual research design was employed in this study. The participants were selected using a non-probability purposive sampling method. Ten participants formed part of the study. To collect data, individual in-depth interviews were conducted. Giorgi's descriptive thematic data analysis was used to analyse data. Measures to ensure trustworthiness and ethical principles were adhered toRESULTS: Three themes emanated: confusion of leadership roles with management roles, confusion of leadership roles with clinical roles and confusion of leadership roles with resources management rolesCONCLUSION: The importance of describing nurse managers' leadership roles surfaced from this study to eradicate confusionCONTRIBUTION: The nurse managers in mPHCs are now understanding their leadership roles, and that leadership roles, management roles, clinical roles and resources management roles are distinguishable <![CDATA[<b>Perceptions and knowledge of school management teams about non-communicable diseases and strategies to prevent them</b>]]> BACKGROUND: In 2016, non-communicable diseases (NCDs) were reported to be responsible for 41 million of the world's 57 million deaths. These deaths were reported to be associated with modifiable lifestyle behaviours, such as tobacco smoking, poor physical activity and diets of poor nutritional value. There could be a knowledge gap on NCD risk factors amongst non-health professionals. Knowledge of NCDs is, therefore, important for the implementation of preventive measures to onset of NCDsAIM: This study aimed at describing perceptions and knowledge of school management teams about NCDs and strategies to prevent themSETTING: This study was conducted in Mt Frere, South AfricaMETHODS: This explorative qualitative study using a phenomenological data collection approach was conducted amongst purposively selected school authorities in 2016-2017 to understand their perceptions and knowledge about NCDs and what can be performed to prevent them. Two focus group discussions (FGDs) were conducted using open-ended and unstructured questions guided by interview schedule. Tesch's eight phases of thematic analysis approach was used to analyse narrative data resulting in two main themes and nine subthemesRESULTS: Two themes (understanding and prevention of NCDs, and control measures for NCDs) and nine sub-themes emerged from the data analysis. Inconsistent description of NCDs, its causes and controls were identified amongst school management teams in the FGD. Diet, poverty, societal factors, gaps between decision makers and communities, and poor policy implementation were identified by participants as major issues in the development of NCDsCONCLUSION: There was no adequate knowledge on NCDs amongst the school management team participants. Improved visibility of health promotion personnel is needed to ensure community empowerment on NCDs preventionCONTRIBUTION: The findings in this study will help in closing the gaps in the implementation of preventive health services for NCDs within school health <![CDATA[<b>Attitudes towards limited drug prescription rights: A survey of South African chiropractors</b>]]> BACKGROUND: Several surveys that have been published show opinions regarding a change in the scope of chiropractic practice to include prescription rights. Currently, research into the attitudes of South African chiropractors towards having this right is non-existentAIM: To ascertain the attitudes of South African chiropractors towards the inclusion of drug prescription rights in their scope of practiceSETTING: The study was conducted on chiropractors registered with the Allied Health Professions Council of South Africa and members of the Chiropractic Association of South AfricaMETHOD: A self-administrative online questionnaire was developed, and sent via email to all registered chiropractors in South Africa in February 2020. Descriptive statistics were used to analyse the dataRESULTS: The response rate for this study was 15.9% (n = 138). 84% (n =105) were in favour of limited prescription rights for over-the-counter medication. However, 79.6% (n = 98) did not agree to full prescriptions rights for non-musculoskeletal drugs. A total of 33.6% (n = 42) rarely recommended OTC and prescription-based analgesics, muscle relaxants and non-steroidal anti-inflammatory drugs (NSAIDs) to their acute patients and 37.9% (n = 52) rarely recommended these drugs to chronic patients. 68.8% (n = 86) were confident in their knowledge of musculoskeletal drugs and 91.2% (n = 112) agreed on further education and training in pharmacology for those practitioners seeking limited medication prescription rightsCONCLUSION: The majority of South African chiropractor respondents indicated an interest in expanding their scope of practice to include limited prescription rightsCONTRIBUTION: These findings could indicate a shift in the attitudes of chiropractors towards drug prescription rights within the profession <![CDATA[<b>Knowledge, attitudes and practices of nurses regarding maternal nutrition in pregnant women at a large hospital and filter clinics, Lesotho</b>]]> BACKGROUND: Adequate nutritional knowledge, positive attitudes, and good practices of nurses regarding maternal nutrition of women during pregnancy are fundamental for maternal and foetal well-beingAIM: This study aimed to determine the knowledge, attitudes, and practices of nurses regarding maternal nutrition in pregnant womenSETTING: A large hospital and its filter clinics in LesothoMETHODS: A descriptive cross-sectional research design was used for this study. The data were collected from 120 nurses working in the reproductive health department of a large hospital and filter clinics, using a self-administered questionnaire. The research was conducted in accordance with the Declaration of HelsinkiRESULTS: The nurses showed good knowledge and practices, and positive attitudes regarding maternal nutrition, 88.3%, 99.2% and 62.5%, respectively. There was a significant relationship between attitude and practice, with a correlation coefficient of r = 296, n = 120, and p = 0.001CONCLUSION: The results of this study show that nurses' practices were associated with their attitudes regarding maternal nutrition, meaning their attitudes regarding maternal knowledge transcends their related knowledgeCONTRIBUTION: The study contributes to the body of literature about the knowledge, attitudes and practices of nurses related to maternal nutrition. It has the potential to lead to the betterment of nursing care, which in turn results in improved pregnancy outcomes in women <![CDATA[<b>The corona chronicles: Framing analysis of online news headlines of the COVID-19 pandemic in Italy, USA and South Africa</b>]]> BACKGROUND: The global coronavirus disease 2019 (COVID-19) pandemic, now in its second year, has resulted in a large corpus of literature in a number of disciplines, particularly virology and epidemiology. In contrast, scholarly inquiry in other areas of the health sciences, particularly in media representations and public health communication, is still emergingAIM: As an integral stakeholder in communication during a pandemic, this descriptive study sought to delineate the media frames of the COVID-19 pandemic in online news headlines in the first month that the COVID-19 was declared a pandemicSETTING: Online news headlines in three global hotspots, namely Italy, the USA and South Africa, during the month of March 2020, were analysedMETHODS: Thematic content analysis and epidemic framing typologyRESULTS: The findings indicate that COVID-19 has been internationally portrayed as a lethal pandemic that destroys and disrupts human life. Discursive frames of consequences monopolised its coverage, whilst discursive frames of reassurance were rare, despite the high survival rate. One of the unique findings of this study is that the COVID-19 pandemic coverage included the naming of positive patients, who were thereby made known to the publicCONCLUSION: Internationally, COVID-19 pandemic coverage used consequence frames that dramatised loss of life instead of deploying frames of reassurance that foreground the high survival rate of this diseaseCONTRIBUTION: Results of the study may help inform public health communication of the COVID-19 pandemic, by offering a detailed description of the frames that journalists use in news headlines, all of which possibly influence public perception of the pandemic. Theoretically, the article has also contributed to the application of epidemic framing typology and has contributed to knowledge in the field of public health communication and the COVID-19 pandemic <![CDATA[<b>Journey less travelled: Female nursing students' experiences in providing intimate care in two nursing education institutions in Gauteng province, South Africa</b>]]> BACKGROUND: Intimate care is not facilitated in South African nursing education and training. Nursing students encounter it for the first time in clinical practice, where they see and touch the naked bodies of patients. The societal segregation of gender roles has led to the feminisation of the nursing profession, suggesting that women are more caring and maternal and that intimate care implementation comes more easily to them than to their male counterpartsAIM: This study explored female nursing students' experiences of intimate care for diverse patientsSETTING: The study was conducted in two nursing education institutions in Gauteng province, South AfricaMETHODS: Descriptive phenomenology was used to describe the lived experiences of participants. Seventeen female nursing students were purposively sampled. Data were collected using semi-structured interviews and analysed using Moustakas' (1994) eight stepsRESULTS: Four themes emerged: intimate care comprehension, preparedness for providing intimate care, reactions in providing intimate care and coping mechanisms when providing intimate care to diverse patientsCONCLUSION: Intimate care forms a basis on which nursing students prioritise the physical needs of patients by providing care that exposes their bodies and requires touch. The students were taught to provide care with respect, maintaining patient autonomy and nursing professionalism. Unfortunately, age and gender barriers create feelings of discomfort and embarrassment. More needs to be done to support and empower nursing students in providing intimate care to diverse patients competently, confidently and comfortablyCONTRIBUTION: Understanding the experiences of participants in providing intimate care to diverse patients will assist nurse educators in intimate care facilitation and support. The female nursing students will be empowered and trained to execute intimate care in a manner that is culturally, religiously and ethically acceptable <![CDATA[<b>COVID-19 as an enabler for enhancing online learning and teaching skills for nurse educators at the University of Namibia: Prospects and challenges</b>]]> BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has caused instability in the education system and has compelled higher education institutions (HEIs) to find alternative ways of teaching and learning by making use of the latest online teaching approachesAIM: The purpose of the study was to explore how COVID-19 could serve as an enabler for the enhancement of online learning and teaching skills for nurse educators at the University of Namibia with specific emphasis on prospects and challengesSETTING: Semi-structured interviews were conducted in English at a public nursing education institution located in the northeast of NamibiaMETHODS: A qualitative explorative, descriptive and contextual research design was used. Data were collected by means of in-depth semi-structured interviews with 18 nurse educators from the School of Nursing. Data were analysed using thematic analysis. Field notes were simultaneously taken to enrich the dataRESULTS: The study revealed three themes: nurse educators' experiences of the use of online learning and teaching skills, COVID-19 as an enabler for enhancing online learning and teaching skills and strategies to sustain online teaching and learningCONCLUSION: Internet technology has generated a surge in demand for web-based teaching and learning. The online learning mode was not effectively utilised during the COVID-19 era because of inadequate technological skills on the part of nurse educatorsCONTRIBUTION: These findings can be used by universities to equip students and academic staff with skills to adapt to e-learning as the new modus operandi in learning and teaching in the post-COVID-19 era <![CDATA[<b>Experiences of nurse managers and practitioners on implementation of an evidence-based practice intervention</b>]]> BACKGROUND: An evidence based practice (EBP) research project was undertaken to implement EBP interventions utilising the Iowa model in order to build the capacity of the nurses in using research evidence to improve decision making and quality careAIM: Exploring and understanding the experiences of nurse managers and practitioners who participated in the EBP change projectSETTING: The study was conducted in the intensive care unit (ICU) of a tertiary hospital in Lilongwe district in MalawiMETHODS: A qualitative approach and an exploratory-descriptive design was employed. The ICU was purposively selected as a unit where the EBP change project was implemented. A purposive sample of 10 nurse managers and practitioners was selected. Semi-structured interviews were conducted. All interviews were audio-recorded with a digital recorder and transcribed verbatim. Thematic analysis was applied to the transcriptsRESULTS: The participants' experiences of implementing EBP interventions were underpinned by four themes namely, evidence-based patient management, effective nursing care, competence in delivering EBP, and factors interplaying in EBP. Use of model, protocol and availability of supportive managers and team were major determinants of EBPCONCLUSION: It is recommended to continue utilising the Iowa Model to facilitate building the EBP capacities of providers during scale upCONTRIBUTION: Utilising the Iowa Model facilitates building of the capacity and empowers frontline nurses to effectively develop, implement and evaluate discipline specific EBP changes needed to improve practice and optimum care <![CDATA[<b>Is medication administration in the elderly influenced by nurses' demographics in South Africa?</b>]]> BACKGROUND: Globally, nurses are increasingly employed post-retirement, with task-shifting to nurses with lower competencies, a lack of knowledge being a barrier, all of which could lead to medication errorsAIM: To describe the impact of nurses' age, experience, training, and skill mix on the medication administration processes in long-term care facilities (LTCFsSETTING: Nurses (N=123) working in 28 LTCFs in the Western Cape province, South AfricaMETHODS: A quantitative non-experimental, cross-sectional descriptive design was used. The LTCFs were divided into funded (state-subsidised) and private (for profit) facilities using a stratified sampling method and each stratum thereafter randomised to obtain equal samples from each stratum. Self-administered questionnaires with close-ended statements were used, and statistical software (SPSS version 27) to perform descriptive and inferential analysesRESULTS: Respondents, (27%), had more than nine years of experience, with 15.8% aged 61-70 years; and 3.5% aged 71-80 years. Some were 'very inexperienced' in computer use (29.3%), 35% received medication training longer than five years ago, and n=28 nurses administered medication outside their scope of practice. The highest sources of job pressure were an increase in workloads (75.6%), being under stress (42.3%), and being overworked (39.0%CONCLUSION: The aging nursing workforce, although experienced, found the job demands, paperwork, and technology barriers. Outdated training and delegating medication administration to lower categories of nurses can lead to medication errorsCONTRIBUTION: This study's findings can serve as a guideline for creating succession plans, recruiting procedures, development, and training of nurses, and improving clinical practices <![CDATA[<b>The midwives' experiences of the use of obstetric triage and obstetric triage tool during labour in Bojanala district</b>]]> BACKGROUND: Obstetric triage (OBT) is a standardised procedure, which plays a vital role in identifying women with obstetric risks upon admission for labour worldwide. In the last few years, considerable attention has been paid to perinatal problem identification programmes, and it has been determined that the inconsistent use of OBT delays midwives' responses to both existing and potential clinical problems amongst women in labour. This delay results in negative and serious perinatal outcomes that could have been prevented. This study was conducted to explore and describe midwives' experiences with OBT in Bojanala districtAIM: This study aimed to explore and describe midwives' experiences with OBT in Bojanala districtSETTING: This study was conducted in Bojanala district of the North West Province. Two public healthcare facilities were selected where midwifery care and OBT services are renderedMETHODS: A qualitative, descriptive, explorative research design was followed. Nine purposefully sampled midwives participated in a one-on-one in-depth interview. Data were analysed using Collaizi's descriptive method based on the themes and categories that emergedRESULTS: Three themes emerged. Midwives experienced the OBT tool to be inadequate; and that the low staff number contributes to an imbalance in the midwife-patient ratio. Midwives were also dissatisfied with less support they receive from their managementCONCLUSION: The study highlighted midwives' experiences of the use of OBT, as presented through their lived experiences. The midwives experienced challenges, which hindered them from practicing OBT to the best of their abilitiesCONTRIBUTION: The study highlighted challenges experienced by midwives regarding OBT, which directly influence the outcomes of pregnancy and labour <![CDATA[<b>In-hospital interventions to promote relational practice with families in acute care settings: A scoping review</b>]]> Relational practice is characterised by genuine interaction between families and healthcare professionals that promotes trust and empowerment. Positive clinical outcomes have been associated with relational practice. To assess and examine in-hospital interventions designed to promote relational practice with families in acute care settings of emergency departments, intensive care units and high care units. The preferred reporting Items for Systematic Reviews and Meta-Analyses guidelines informed the design of this scoping review. To identify relevant studies, databases (Academic Search Complete; CINAHL; PubMed; PsyInfo) and the search engine Google Scholar were searched using terms for core elements of relational practice and family engagement. Of the 117 articles retrieved, eight interventional studies met the search criteria. The interventions focused on relational practice elements of collaborating with and creating safe environments for families, whilst only one addressed healthcare professionals being respectful of families' needs and differences. In relation to the nature of engagement of families in interventions, the focus was mainly on improving family functioning. Family engagement in the interventions was focused on involving families in decision-making. The scoping review revealed a limited number of in-hospital interventions designed to promote relational practice with families in acute care settings. Further research is encouraged to develop such interventions.CONTRIBUTION: The scoping review has highlighted specific elements of relational practice that have been overlooked in the mapped interventions. This provides guidance on where future interventional research may be focused <![CDATA[<b>A report of a South African university's management of undergraduate nursing students' teaching and learning following the COVID-19 interruptions</b>]]> The coronavirus disease 2019 (COVID-19) pandemic exposed an absence of blueprints to avert an education disaster. In South Africa, in line with Alert Level-5, adhering to lockdown restrictions, higher education institutions (HEIs) closed, necessitating the transition to online teaching and learning. The HEIs, inclusive of the nursing discipline, needed to develop comprehensive plans and a rigorous follow-up scheme in order to ensure that faculty and students made proper use of virtual platforms and simultaneously met regulatory body requirements, thus ensuring that 'no student and faculty were left behind'. The responses varied from one HEI to another. The objective of this study was to present how a South African nursing education faculty managed teaching and learning following COVID-19-related interruptions. This included an HEI in KwaZulu-Natal, South Africa. Donabedian's tripartite model, comprising structure, process and outcome, provides the organising structure to present the faculty and university's approach to meet the desired outcome of saving the 2020 academic year. The Structures' and Processes' components of Donabedian's tripartite model influenced both intended and unintended outcomes. In 3 months, what might have been argued as impossible, a 4-year undergraduate nursing programme was transitioned from a traditional approach to fully virtual remote teaching and learning. Thus, the 2020 academic year was saved.CONTRIBUTION: This article offers guidance to HEIs on how to continue teaching and learning in contexts where education is interrupted <![CDATA[<b>Perspectives of healthcare workers in South Africa on COVID-19 vaccination passports</b>]]> BACKGROUND: Following the rollout of several effective vaccines against coronavirus disease 2019 (COVID-19), many countries have introduced vaccination passports or certificates as a means of certifying that an individual has been vaccinated against, is immune to, or is presently uninfected with COVID-19. An extensive ethical debate has ensued. AIM: To determine the perspectives of South African healthcare workers (HCWs) on the implementation of COVID-19 vaccination passports (C19VPs) in South Africa (SA). SETTING: Healthcare workers working in various fields and practice settings throughout SA were invited to complete an online questionnaire. METHODS: An online questionnaire was distributed using convenience sampling via social media platforms to HCWs over a 1-month period, collecting demographic details and responses to 8 Likert-type items regarding agreement with C19VPs, ethical issues and feasibility. Each item was graded from 1 (strongly disagree) to 5 (strongly agree), with grouping of 4 of the 8 items exploring a common theme of C19VPs being a good idea, constituting a score out of 20. Non-parametric tests were performed to determine differences in responses between groups. RESULTS: One thousand HCWs responded to the survey and fulfilled inclusion criteria. The majority (83.2%) of respondents were medical practitioners (MPs). Overall, most (73.5%) respondents agreed that C19VPs are a good idea. Older respondents agreed more strongly than younger respondents (medians 18 and 17, respectively, p = 0.001), and respondents in private practice agreed more strongly than those in state practice (medians 18 and 16, respectively, p = 0.042). The median response was neutral (3) in response to the ethics of C19VPs considering variations in vaccine access and tending towards disagreement (2.5) in disadvantaging poorer people. Most respondents disagreed that vaccine hesitancy would make C19VPs unethical, and responses from provinces with the highest vaccination proportions disagreed more than others with lower vaccination proportion (median 2 compared with 3, p < 0.001). There was uncertainty about the feasibility of C19VPs in SA, with older HCWs, non-students, senior MPs and those who thought C19VPs are a good idea being more likely to consider them feasible. CONCLUSION: The perspectives of HCWs, mainly MPs, about C19VPs in SA were obtained. Further research should focus on vaccine hesitancy and its factors in HCWs and the effect of C19VPs on restrictions, reduction in transmission and benefits on economies and mental health. CONTRIBUTION: To the authors' knowledge, this is the first survey data published on the perspectives of South African HCWs on C19VPs in the country. Healthcare workers are trusted influencers of vaccination decisions, and their opinion on vaccination certificates may also influence the South African public's perception and acceptance thereof. <![CDATA[<b>Self-management experiences of youth following the unexpected loss of a family member to HIV</b>]]> BACKGROUND: Death of a close family member is one of the most traumatic events in a person's life. The way, in which this loss unfolds, varies from person to person and depends on how close you were with the deceased. It was unclear how youths experienced it to manage themselves during different stages of the bereavement process, after losing a near-family member to human immunodeficiency virus (HIV). AIM: The aim of this study was to understand the self-management of youth following the unexpected loss of a family member to HIV. SETTING: Khayelitsha, Western Cape province, South Africa. METHODS: A descriptive phenomenological design was followed, with an accessible population of youth who lost a family member to HIV. Individual semi-structured interviews were conducted with 11 purposively selected participants after obtaining written informed consent. The sessions, held with an interview schedule, did not take longer than 45 min to conduct until data saturation was reached. A digital recorder was used and field notes held. Open coding was followed after transcribing interviews RESULTS: Individuals had different experiences during different stages of the bereavement process, not necessarily similar or following the same sequence. Individuals had to manage their guilt of being unable to do more before the family member passed away, struggling to realise that they have a future purpose, and hardship having fond memories. CONCLUSION: Youth find it difficult to view death as a natural loss of life and to manage themselves after the loss of their loved one to HIV. CONTRIBUTION: The context-based information in this study confirms the importance of youth and self-coping and self-continuation to plan, organise and direct their future after the loss of a family member. <![CDATA[<b>Human errors and factors that influence patient safety in the pre-hospital emergency care setting: Perspectives of South African emergency care practitioners</b>]]> BACKGROUND: Delivering pre-hospital emergency care has the potential to be hazardous. Despite this, little is known about the factors that precipitate human errors and influence patient safety in the pre-hospital care setting, in contrast to in-hospital care. Similarly, limited report on patient safety and human error issues in the pre-hospital emergency care setting exist in South Africa. AIM: This study investigated the perspectives of emergency care personnel (ECP) in South Africa on the types of human errors and factors that precipitate human errors that influence patient safety in the pre-hospital emergency care setting in South Africa SETTING: This study was conducted in the pre-hospital emergency care environment in South Africa. METHODS: This research was designed as an exploratory study that made use of a semi-structured questionnaire administered to 2,000 emergency care personnel. RESULTS: A response rate of 76% was obtained. According to the participants, errors relating to poor judgement, poor skill or knowledge, fatigue, and communication, and individual error are common during pre-hospital care. Inadequate equipment, environmental factors, and personal safety concerns were reported as some of the factors that influence patient safety in the pre-hospital emergency care setting. CONCLUSION: Implementation of strategies that enhances education and training, clinical skill development, teamwork skills, fatigue management, and leadership skills can help prevent some of the errors identified in this study. CONTRIBUTION: This study identifies the types of human errors, and factors that precipitate human errors that influence patient safety in the pre-hospital emergency care setting in South Africa. <![CDATA[<b>Public healthcare practitioners' knowledge, attitudes and practices related to oral antibiotic prescriptions for dental use in Pietermaritzburg, KwaZulu-Natal</b>]]> BACKGROUND: There is limited published evidence on health workers' perspectives on trends in oral antibiotic prescription for dental conditions in the public health sector. AIM: This study set to determine healthcare practitioners' knowledge, attitudes and practices related to oral antibiotic prescriptions for dental use. SETTING: This included two public hospitals in Pietermaritzburg. METHODS: This was a cross-sectional study using quantitative data. Purposive sampling was used to select medical and dental practitioners from Institution A and B (n = 122). A self-administered questionnaire was developed using open and close-ended questions. Data were collected and analysed using the Statistical Package for Social Sciences (IBM SPSS version 25R). RESULTS: The response rate for the study was 72.1%. The majority of study participants (n = 72, 81.8%) indicated awareness of an antibiotic stewardship programme in their respective institutions. However, a significant number (n = 42; 47.7%) of participants were unsure of whether this programme was active. Most participants (n = 80, 90.9%) indicated the need for improving oral antibiotic prescription for dental conditions. Participants indicated prescription of antibiotics for orofacial swellings (n = 52; 59.0%) and dental pain related to irreversible pulpitis (n = 29; 32.9%), reversible pulpitis (n = 33; 37.5%) and dental fillings (n = 15; 17.0%). Antibiotics were also prescribed for pericoronitis (n = 58; 65.9%), periodontitis (n = 57; 64.7%) and impacted teeth (n = 21; 23.8%). All dental practitioners (n = 14) supported the need for antibiotic cover for pericoronitis and periodontitis. CONCLUSION: The results indicated inconsistencies in healthcare practitioners' reported knowledge, attitudes and practices related to antibiotic prescription patterns. CONTRIBUTION: This study highlights the need for clear evidence-based guidelines for antibiotic prescription for dental conditions. <![CDATA[<b>Information technology for teaching and learning in a multi-campus public nursing college</b>]]> BACKGROUND: Technologies, such as the use of information technology for teaching and learning, e-learning and virtual learning, are commonly used terms in today's education system. These ever growing and developing modes of teaching and learning have changed the landscape of higher education, in general. As a result, nursing education has equally responded positively to the use of information technology for teaching and learning. AIM: The aim of this study was to describe and compare the readiness to use information technology for teaching and learning for both nursing students and nurse educators in the two campuses of a North West public nursing college. SETTING: The study was conducted in a multi-campus North West public nursing college in South Africa. METHODS: A quantitative approach of a comparative descriptive design was followed in this study. Descriptive statistics was analysed using the Statistical Package for the Social Sciences (SPSS) Version 27. RESULTS: A total of 285 (254 nursing students and 31 nurse educators) respondents completed the online questionnaires. Both nurse educators and nursing students were in agreement with the information technology use readiness construct (83.9% and 77.9%, respectively). For all the variables with significant (< 0.05) p-values from the Mann-Whitney U test, the mean ranks were higher for the Ngaka Modiri Molema District (NMMD) campus. CONCLUSION: When comparing the two campuses, conclusion can be drawn that the campus at NMDD is more ready to use information technology for teaching and learning than the campus at Dr Kenneth Kauda District. CONTRIBUTION: The results of this study contribute to the body of knowledge on technology use for teaching and learning in nursing education. <![CDATA[<b>Knowledge, attitudes and behaviours toward COVID-19: A cross-sectional survey among Nigerian University students</b>]]> BACKGROUND: The effect of the highly contagious coronavirus disease 2019 (COVID-19) began in Wuhan, Hubei Province, China, from which it spread worldwide. In Nigeria, to curb the spread of the virus, the government elected to close public places, halt the general use of public transportation, enforce isolation and manage infected persons. AIM: This study evaluated Nigerian university students' knowledge, attitudes and behaviour (KAB) towards COVID-19. SETTING: This was an online survey of Nigerian university students METHOD: A cross-sectional study was conducted among 1268 respondents aged 16 to 60 who completed the survey questionnaire. The respondents' demographic data and KAB toward COVID-19 were collected, allocated and scored based on specific stratified divisions. Data were analysed using student's t-test, analysis of variance and logistic regression analysis. RESULTS: The respondents demonstrated good knowledge of COVID-19, with a mean knowledge score of 78.7%; this positively influenced their attitude and behaviour scores (84.1% and 72.3%, respectively). Multiple linear regression analysis showed that 98.9% of the variance associated with poor knowledge is explained by gender (98.9%), age (97.3%), education (97.3%), occupation (97.2%) and marital status (91.4%). CONCLUSION: The respondents had a positive attitude and satisfactory compliance with safety practices required to curb the spread of the virus. Nevertheless, there is a need to intensify health education campaigns targeting all Nigerians, especially the less educated, via community outreach programmes using local languages. CONTRIBUTION: The findings of this study demonstrate the imperative role of the knowledge of COVID-19 in curbing the spread of the infection via improved attitudes and positive behaviours in compliance with safety practices. <![CDATA[<b>Best practice recommendations for healthy work environments for nurses: An integrative literature review</b>]]> Healthy work environments that maximise the health and well-being of nurses are essential in achieving good patient and societal outcomes, as well as optimal organisational performance. While studies have been conducted on healthy work environments, there is no available evidence that an integrative literature review summarising best-practice recommendations related to healthy work environments has been conducted before. This review aimed to summarise existing best-practice recommendations related to a healthy work environment for nurses. An integrative literature review following the approach adapted from Whittemore and Knafl was used. Existing guidelines related to healthy work environments for nurses were searched. EBSCOhost (CINAHL, Medline), Biomed Central, Science Direct, PubMed and Google Scholar and organisational websites via Google were searched, followed by a citation search. Twelve guidelines were identified for data extraction and synthesis, and themes were subsequently formulated. Four themes emerged from the integrative literature review regarding a healthy work environment for nurses: (1) the need for effective nursing leadership, (2) effective communication as central to enhancement of a healthy environment, (3) effective teamwork as an integral part of a healthy work environment and (4) the need for professional autonomy. In summary, a healthy work environment for nurses requires leadership, effective communication, teamwork and professional autonomy. CONTRIBUTION: The findings can be used to conduct quality studies related to healthy work environments for nurses in comprehensive health care settings, particularly those dealing with resource constraints. This can inform evidence-based recommendations and guidelines in these settings, as such guidelines are currently lacking <![CDATA[<b>Support interventions for nurses working in acute psychiatric units: A systematic review</b>]]> Diverse support interventions have been implemented to provide support for nurses working in acute psychiatric settings. These interventions aimed at modifying the psychological and social factors, as they either prevent stress responses or reduce its effects to improve the psychological well-being of staff. This study aimed to examine effective stress reduction interventions for nurses and to identify key elements of these successful interventions. Studies included in this review were conducted in acute psychiatric settings. A comprehensive search of electronic databases was conducted for support intervention studies between 2010 and 2021. The search yielded 315 studies that were reduced to seven studies after being reviewed by two independent reviewers. The studies were coded, and key elements were identified. Seven studies that were included consisted of a randomised controlled trial, quasi-experimental design and single-group design. Interventions included mindfulness-based stress reduction, burnout prevention programmes, communication skills, educational programme, group intervention, resilience training programme and stress management. Four key elements emerged from these interventions, namely, educational support, interpersonal skills, psychological support and adaptive coping. The findings highlighted the diverse interventions in supporting psychiatric nurses to cope with stress. However, there is a dearth of studies in acute psychiatric settings that were mostly done in emergency settings. Knowledge gained from this review may assist with practice improvement as managers can implement the identified interventions. CONTRIBUTION: This is the first systematic review focusing on supportive interventions for nurses in acute psychiatric settings. The knowledge gained from this review will add to the existing research knowledge base in the field <![CDATA[<b>Nurses' roles in changing practice through implementing best practices: A systematic review</b>]]> Nurses play an important role in the implementation of best practices. However, the role of nurses in changing practice by implementing best practices requires further exploration. No systematic review was found that summarised the best available evidence on the roles of nurses in changing practice through the implementation of best practices. This study summarised the best available evidence on the roles of nurses in changing practice through the implementation of best practices. A systematic review was used to search for studies in the English language, where a best practice was implemented in a clinical context and which included findings regarding the roles of nurses when implementing best practices. Scopus, EBSCOhost (Academic Search Ultimate, APA PsycInfo, CINAHL with Full Text, ERIC, Health Source: Nursing/Academic Edition, MasterFILE Premier, MEDLINE Complete), PUBMED, and ScienceDirect databases were searched from January 2013 to June 2021. The search generated 1343 citations. After removing duplicates and applying eligibility criteria, 27 studies were included. Five definite roles were identified as follows: leadership, education and training, collaboration, communication and feedback and development and tailoring of the best practice. These roles are interrelated, but equally crucial in order to implement best practices. This study found five interrelated but equally crucial nurse roles in changing practice through the implementation of best practices. CONTRIBUTION: The study's findings and gaps identified can be used for further nursing research, improving practice change and health outcomes through the implementation of best practices and the role nurses can play in this process